The term "sadistic abuse" is proposed to designate extreme adverse experiences which include sadistic sexual and physical abuse, acts of torture, over-control, and terrorization, induction into violence, ritual involvements, and malevolent emotional abuse. Individuals with these extreme childhood histories may present with severe and multiple symptoms and a prolonged complicated treatment course. Adherence to basic principles of trauma-based treatment is recommended as is reference to relevant databases which include not only those materials concerning severe child abuse and family violence, but also literatures describing torture, the holocaust, prostitution, pornography and sex rings, cult abuse, and sadistic criminals.